继发孔型房间隔缺损三种术式比较分析

目的 通过比较三种术式,探讨房间隔缺损手术治疗的发展趋势.方法 回顾分析127例继发孔型房间隔缺损患者资料,采用正中切口体外循环下直视修补68例（A1组）,右腋下小切口体外循环下直视修补39例（A2组）,非体外循环彩超引导下封堵手术20例（B组）,比较三种手术方式的手术时间、ICU时间、切口长度等.结果 A1、A2组除手术切口长度及术后住院时间外,其余指标差异无统计学意义.B组除在手术成功率及术后并发症方面均优于A1及A2组,差异有统计学意义.结论 房间隔缺损治疗已由正中切口体外循环下直视修补,发展为右腋下小切口体外循环下直视修补;现在非体外循环彩超引导下封堵手术作为一种微创技术,以其操作简单,术后恢复快,安全可靠,优于体外循环直视修补术,被越来越多心外科医生所采用.

Comparative analysis of three surgical treatment of atrial septal defection

Objective To explore the surgical treatment trends in patients with secundum atrial septal defect （ASD）. Methods 68 patients treated by surgery with extracorporeal circulation （ECC） through median sternotomy incision （group A1 ） ,39 pa- tients treated by surgery with ECC through right axillary incision （group A2）, and 20 patients treated by transthoracic closure guidance with transthoracic echocardiography （TEE） without ECC （group B） were enrolled in this study to compare the mean surgical time,ICU time, the length of incision. Results There was no significant difference in group A1 and group A2 except the operation incision length and post - operation hospitalization time. The group B performs better than that in group A1 and A2 （P 〈 0.05 ）. Conclusion Treatment of ASD is evolving from median sternotomy incision to the right axillary incision with ECC. Transthoracic closure of ASD, as a minimally invasive surgical technology,with its simple operation, rapid postoperative recovery, safety and reliability, demonstrates its superiority to surgery with ECC, and are increasingly used by cardiac surgeons.